去氧孕烯炔雌醇对围绝经期功能失调性子宫出血的疗效及激素水平影响

Effect of desogestrel and ethinylestradiol in the treatment of perimenopausal dysfunctional uterine bleeding and its influence on the serum hormone levels

目的分析去氧孕烯炔雌醇对围绝经期功能失调性子宫出血患者的疗效及血清激素水平的影响。方法选取诊治的围绝经期功能失调性子宫出血患者60例作为研究对象,根据随机数字表法均分为2组,每组30例。对照组给予米非司酮治疗,研究组给予米非司酮联合去氧孕烯炔雌醇治疗。1个疗程均为21 d,连续治疗6个疗程,随访6个月。比较2组患者的临床疗效、子宫内膜厚度、出血控制时间、完全止血时间、不良反应、复发率以及血清雌二醇(E 2)、卵泡刺激素(FSH)、黄体生成素(LH)和孕酮(Pro)水平。结果治疗后,研究组总有效率为93.33%,显著高于对照组的73.33%(P<0.05);研究组阴道出血控制时间及完全止血时间均显著短于对照组(P<0.05);研究组血清E 2、FSH、Pro以及LH水平显著低于对照组(P<0.05);研究组子宫内膜厚度显著小于对照组,血红蛋白显著高于对照组(P<0.05);2组患者不良反应发生率比较差异无统计学意义(P>0.05);随访6个月,研究组复发率显著低于对照组(P<0.05)。结论在米非司酮治疗基础上给予去氧孕烯炔雌醇,可显著提高围绝经期功能失调性子宫出血患者的临床疗效,并缩短临床症状缓解时间,减少复发,降低血清激素水平,且未增加不良反应的发生,值得临床重视。

Objective To analyze the effect of desogestrel and ethinylestradiol in the treatment of perimenopausal dysfunctional uterine bleeding and its influence on the serum hormone levels.Methods 60 cases of perimenopausal dysfunctional uterine bleeding in our hospital were collected and divided into 2 groups according to the random number table method,each group had 30 cases.The control group was treated with mifepristone,while the study group was treated with mifepristone,desogestrel and ethinylestradiol tablets.The course of treatment was 21 d,and 6 courses were treated continuously.All the patients were followed up for 6 months.The effective rate,endometrial thickness,the time of vaginal bleeding control and complete hemostasis,the incidence of adverse reactions,the relapse rate,and the levels of serum E 2,FSH,LH and Pro between the 2 groups were compared.Results After treatment,the total effective rate the study group was 93.33%,which was significantly higher than 73.33%of the control group(P<0.05).The time of vaginal bleeding control and complete hemostasis in the study group were significantly lower than those in the control group(P<0.05).The levels of serum E 2,FSH,Pro and LH in the study group were significantly lower than those in the control group(P<0.05).The endometrial thickness of the study group was significantly lower than that of the control group,and hemoglobin was significantly higher than that of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the 2 groups(P>0.05).After 6 months of follow-up,the relapse rate of the study group was significantly lower than that of the control group(P<0.05).Conclusion On the basis of mifepristone treatment,deoxygestation with estriol can significantly improve the clinical efficacy of perimenopausal dysfunctional uterine bleeding,shorten the time of remission of clinical symptoms,reduce the occurrence of recurrence,reduce the level of serum hormone,and do not increase the occurrence of adverse reactions.It is worthy of clinical attention.